| Mattawa Community Medical Clinic | |
|
210 Government Road Mattawa WA 99349-0960 | |
| (509) 932-4499 | |
| (509) 932-5363 |
| Full Name | Mattawa Community Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 210 Government Road, Mattawa, Washington |
| Authorized Official Name and Position | Dana S Fox (CEO/EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5099324499 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mattawa Community Medical Clinic Po Box 1581 Mattawa WA 99349-0960 Ph: (509) 932-4499 | Mattawa Community Medical Clinic 210 Government Road Mattawa WA 99349-0960 Ph: (509) 932-4499 |
| NPI Number | 1699720797 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 12/16/2019 |
| Medicare PECOS PAC ID | 3274525837 |
|---|---|
| Medicare Enrollment ID | O20040401001562 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699720797 | NPI | - | NPPES |
| 7900657 | Other | WA | DSHS TAKE CHARGE |
| 501944 | Other | WA | MEDICARE PTAN |
| 67850 | Other | WA | LABOR & INDUSTRIES |
| 7035611 | Other | WA | DSHS FEE FOR SERVICE |
| 7406572 | Other | WA | DSHS MSS |
| 7044167 | Medicaid | WA |
| Provider Name | Daniel E Sloane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427003540 PECOS PAC ID: 1456346535 Enrollment ID: I20040417000631 |
| Provider Name | Mara L Fusfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992871107 PECOS PAC ID: 2769408640 Enrollment ID: I20080424000531 |
| Provider Name | Nicole L Avila-parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295192540 PECOS PAC ID: 9032416474 Enrollment ID: I20160329002750 |
| Provider Name | Jennifer A Beaty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134337785 PECOS PAC ID: 1254628571 Enrollment ID: I20160929001094 |
| Provider Name | Josilyn Brook Baugher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285311951 PECOS PAC ID: 3577927516 Enrollment ID: I20230911000744 |
| Provider Name | Sarah Michelle Charlton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700648102 PECOS PAC ID: 6002256138 Enrollment ID: I20240506003673 |
| Provider Name | Sally Anne Myer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053098749 PECOS PAC ID: 5698126423 Enrollment ID: I20240523001108 |
Grant County Public Hospital District No.5 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 Government Rd, Mattawa, WA 99349 Phone: 509-932-4499 Fax: 509-932-5363 | |
Wahluke Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 601 Government Way, Mattawa, WA 99349 Phone: 509-932-3535 Fax: 509-488-9939 | |
Mattawa Community Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 William Ave, Mattawa, WA 99349 Phone: 509-932-4499 Fax: 509-932-5363 | |
Columbia Basin Health Association Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 Government Way, Mattawa, WA 99349 Phone: 509-488-5256 Fax: 509-488-9939 |